The lymphatic system is part of the circulatory system, comprising a network of conduits called lymphatic vessels that carry

a clear fluid called lymph (from Latin lympha "water goddess"[1]) directionally towards the heart The lymphatic system was first descri!ed in the seventeenth century independently !y "laus #ud!eck and Thomas $artholin The lymph system is not a closed system The circulatory system processes an average of %& litres of !lood per day throughcapillary filtration which removes plasma while leaving the !lood cells #oughly 1' litres of the filtered plasma actually get rea!sor!ed directly into the !lood vessels, while the remaining ( litres are left !ehind in the interstitial fluid The primary function of the lymph system is to provide an accessory route for these e)cess ( litres per day to get returned to the !lood [%] Lymph is essentially recycled !lood plasma Lymphatic organs play an important part in the immune system, having a considera!le overlap with the lymphoid system Lymphoid tissue is found in many organs, particularly the lymph nodes, and in the lymphoid follicles associated with thedigestive system such as the tonsils Lymphoid tissues contain lymphocytes, !ut they also contain other types of cells for support [(] The system also includes all the structures dedicated to the circulation and production of lymphocytes (the primary cellular component of lymph), which includes the spleen, thymus, !one marrow, and the lymphoid tissue associated with the digestive system [*] The !lood does not directly come in contact with the parenchymal cells and tissues in the !ody, !ut constituents of the !lood first e)it the microvascular e)change !lood vessels to !ecome interstitial fluid, which comes into contact with the parenchymal cells of the !ody Lymph is the fluid that is formed when interstitial fluid enters the initial lymphatic vessels of the lymphatic system The lymph is then moved along the lymphatic vessel network !y either intrinsic contractions of the lymphatic passages or !y e)trinsic compression of the lymphatic vessels via e)ternal tissue forces (e g the contractions of skeletal muscles) The organi+ation of lymph nodes and drainage follows the organi+ation of the !ody into e)ternal and internal regions, therefore, the lymphatic drainage of the head, lim!s, and !ody cavity walls follows an e)ternal route, and the lymphatic drainage of the thora), a!domen, and pelvic cavities follows an internal route [-] .ventually, the lymph vessels empty into the lymphatic ducts, which drain into one of the two su!clavian veins(near the /unctions of the su!clavian veins with the internal /ugular veins)

"ur !odies have a network of lymph (limf) vessels and lymph nodes This network collects fluid, de!ris, and other things that are in the !ody0s tissue, outside the !loodstream

Lymph vessels are a lot like the veins that collect and carry !lood through the !ody $ut instead of carrying !lood, these vessels carry the clear watery fluid called lymph

Lymph flows out from capillary walls to !athe the cells in the tissues of the !ody 1t carries o)ygen and other nutrients to those cells 1t also contains white !lood cells, which help fight infections 2aste products like car!on dio)ide (3" 2) can flow out of the cells and into lymph Lymph fluid would !uild up and cause swelling if it were not drained in some way That0s the role of the lymph vessels Lymph vessels draw up the lymph fluid from around the cells to send it towards the chest There, lymph collects into a large vessel that drains into a !lood vessel near the heart

Lymph nodes and what they do

Lymph vessels route the fluid through nodes throughout the !ody Lymph nodes are small structures that work as filters for harmful su!stances They contain immune cells that can help fight infection !y attacking and destroying germs in the lymph fluid

There are hundreds of lymph nodes throughout the !ody .ach lymph node filters fluid and su!stances picked up !y the vessels that lead to it Lymph fluid from the fingers, for instance, works its way toward the chest, /oining fluid from the arm This fluid may filter through lymph nodes at the el!ow, or those under the arm 4luid from the head, scalp, and face flows down through lymph nodes in the neck 5ome lymph nodes are deep inside the !ody, such as !etween the lungs or around the !owel, to filter fluid from those areas The lymph slowly flows in from all around the !ody, making its way !ack to the chest 6t the end of its /ourney, the filtered fluid, salts, and proteins are dumped !ack into the !loodstream

Cancer in the lymph nodes

3ancer can appear in the lymph nodes in two ways7 it either starts there or spreads there from somewhere else 3ancer that starts in the lymph nodes is called lymphoma 8ou can read more a!out lymphoma in our documents called Hodgkin Disease and Non-Hodgkin Lymphoma 9ore often, cancer starts somewhere else and then spreads to lymph nodes That is the focus of this document

How does cancer spread to lymph nodes?

3ancer can spread from where it started (the primary site) to other parts of the !ody 2hen cancer cells !reak away from a tumor, they can travel to other areas of the !ody through either the !loodstream or the lymph system 3ancer cells can travel through the !loodstream to reach distant organs 1f they travel through the lymph system, the cancer cells may end up in lymph nodes .ither way, most of the escaped cancer cells die or are killed !efore they can start growing somewhere else $ut one or two might settle in a new area, !egin to grow, and form new tumors This spread of cancer to a new part of the !ody is called metastasis 1n order for cancer cells to spread to new parts of the !ody, they have to go through several changes They have to !e a!le to !reak away from the original tumor and attach to the wall of a lymph vessel or !lood vessel Then they must move through the vessel wall to flow with the !lood or lymph to a new organ or lymph node 2hen cancer grows inside lymph nodes, it usually affects the lymph nodes near the tumor itself These nodes are the ones that have !een doing most of the work to filter out or kill the cancer cells

How is cancer in lymph nodes found?

:ormal lymph nodes are tiny and can !e hard to find, !ut when there0s infection, inflammation, or cancer, the nodes can get larger Those near the !ody0s surface often get !ig enough to feel with your fingers, and some can even !e seen $ut if there are only a few cancer cells in a lymph node, it may look and feel normal 1n that case, the doctor must check for cancer !y removing all or part of the lymph node

2hen a surgeon operates to remove a primary cancer, one or more of the near!y (regional) lymph nodes may !e removed as well #emoval of one lymph node is called a biopsy 2hen many lymph nodes are removed, it0s calledlymph node sampling or dissection 2hen cancer has spread to lymph nodes, there is a higher risk that the cancer might come !ack after surgery This information helps the doctor decide whether more treatment, like chemo or radiation, might !e needed after surgery ;octors may also take samples of one or more nodes using needles <sually, this is done on lymph nodes that are enlarged This is called a needle biopsy The tissue that0s removed is looked at under the microscope !y a pathologist (a doctor who diagnoses illness using tissue samples) to find out if there are cancer cells there <nder the microscope, any cancer cells in the nodes look like cells from the primary tumor 4or instance, when !reast cancer spreads to the lymph nodes, the cells in the nodes look like !reast cancer cells The pathologist prepares a report, which details what was found 1f a node has cancer in it, the report descri!es what it looks like and how much was seen ;octors may also use scans or imaging studies to look for enlarged nodes around a cancer if the nodes are deep in the !ody "ften, enlarged lymph nodes near a cancer are assumed to contain cancer